Wingspan experience in the treatment of symptomatic intracranial atherosclerotic disease after antithrombotic failure
- Edgar A Samaniego1,2,
- Francesca Tari-Capone3,
- Italo Linfante1,2,
- Christine F Silva4,
- Gabriela Spilberg4,
- Matthew Gounis4,
- Ajay K Wakhloo4,
- Guilherme Dabus1,2
- 1Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, Miami, FL, USA
- 2Department of Neurointerventional Surgery, Baptist Neuroscience Center, Miami, FL, USA
- 3Department of Neuroscience, Mental Health and Sensory Organs, University of Rome ‘La Sapienza’, Rome, Italy
- 4Department of Radiology, New England Center for Stroke Research, University of Massachusetts Medical School, Worcester, MA, USA
- Correspondence to Dr G Dabus, Department of Neurointerventional Surgery, Baptist Cardiac and Vascular Institute, 8900 N Kendall Drive, Miami 33156, Florida, USA;
Contributors Study concept and design: IL, GD and EAS. Acquisition of the data: FT-C, EAS, MG, GS and CFS. Analysis and interpretation of the data: EAS, FT-C and GD. Drafting of the manuscript: GD, IL and EAS. Critical revision of the manuscript for important intellectual content: all authors. Administrative, technical and material support: EAS and FT-C. Study supervision: GD.
- Received 23 February 2012
- Revised 21 March 2012
- Accepted 23 March 2012
- Published Online First 27 April 2012
Background and purpose Intracranial stenting with the Wingspan system has been used as a revascularization strategy in symptomatic patients with intracranial atherosclerotic disease (ICAD). The latest results of the Stenting versus Aggressive Medical Therapy for Intracranial Artery Stenosis (SAMMPRIS) trial challenge this approach. Our experience in the treatment of symptomatic ICAD with the Wingspan system is reported.
Materials and methods Patients who underwent stenting for symptomatic ICAD were included in the analysis. Demographic data, periprocedural complications, long term radiological and clinical outcomes are reported.
Results 46 lesions were treated in 45 patients. 13 patients (29%) presented with a transient ischemic attack and 32 (71%) with a stroke. 43 patients (95.5%) failed antithrombotic therapy at presentation. One (2%) symptomatic periprocedural (24 h) complication occurred. The 30 day incidence of stroke and vascular death was 6.6%—a fatal hemorrhagic stroke and two non-fatal hemorrhagic strokes. In-stent stenosis (≥50%) was seen in nine (42.8%) lesions, two were symptomatic.
Conclusions This cohort of patients with symptomatic ICAD who failed antithrombotic medications benefited from angioplasty and stenting with the Wingspan system.
Competing interests None.
Ethics approval Ethics approval was provided by the institutional review board committee.
Provenance and peer review Not commissioned; not externally peer reviewed.